Text Size

DEMS VIE FOR WAXMAN’S ENERGY AND COMMERCE SLOT — Rep. Henry Waxman’s announced retirement set off an instant scramble among Democrats to claim his spot as the top Democrat on the powerful Energy and Commerce Committee. Reps. Anna Eshoo (D-Calif.) and Frank Pallone (D-N.J.) announced almost simultaneously their interest in the post. And Rep. John Dingell, (D-Mich.) is considering a return to the job he held until Waxman bested him for it. The winner could be instrumental in fighting Republican efforts to undermine Obamacare. http://politico.pro/1blm4Zh

OBAMACARE PROBLEMS HAVE GOP SEEING RED IN MASSACHUSETTS – Republicans in Massachusetts — an endangered species — are hoping Obamacare can help them claw back from the brink of irrelevance. The party’s top contenders for the U.S. House and governor this year are seeking full exemptions from the federal health law to preserve the state’s seven-year-old system, RomneyCare. It’s a narrative that’s been fueled by a high-profile meltdown of the state’s exchange, the Connector, as it ramped up to adjust to Obamacare. “No other state has suffered more from Obamacare than Massachusetts,” said Republican Richard Tisei, who’s running a rematch this year against Democratic Rep. John Tierney. Tierney’s camp says Tisei is overshooting, and other Democratic strategists say there’s still time to fix what’s broken, but Republicans plan on employing this line of attack throughout the 2014 campaign. http://politico.pro/1eNM3JQ

Happy Tuesday and welcome to PULSE

“I've got a PULSE that cannot sleep at night when something just ain't right.”

GOP EYEING THE MEANING OF “FULL-TIME” — Curtain’s up on Republican efforts to rewrite Obamacare’s definition of full-time work. Republicans on the House Ways and Means Committee are pushing for a proposal to change the definition to 40 hours a week, from the health law’s 30. Pro’s Paige Winfield Cunningham reports: “Advocates say the change would preserve full-time employment by removing an incentive for employers to cut workers’ weekly hours below 30. Once the employer mandate begins in 2015, the law’s current language will require mid-size and large businesses to provide health coverage to all workers classified as full-time. But opponents argue that the bill could just shift the problem, not solve it.” It’s not a purely partisan issue. Democrats have signed onto a similar bill offered by Rep. Dan Lipinski (D-Ill.) http://politico.pro/1akMY8z

REPORT: OBAMACARE DELAYS HANG OVER IRS — The on-the-fly reworking of major Affordable Care Act provisions could threaten the IRS’s ability to handle customer service, according to a new report by the Treasury Inspector General for Tax. “Changes in the implementation of ACA tax provisions can result in increased demand for customer service assistance resulting in more contacts with the IRS,” the inspector general found. Pro Tax’s Lauren French reports: http://politico.pro/1bXvtGo

RUBIO TO TESTIFY ON OBAMACARE “BAILOUT” COMPLAINTS — Sen. Marco Rubio will testify Wednesday morning before the House Oversight Committee on provisions in the Affordable Care Act intended to shield insurers who take on a disproportionate number of high-risk patients. Republicans are charging that the provisions amount to a “bailout” for insurers and are leading to higher premiums for customers outside the insurance exchanges. Doug Badger, a former senior health advisor to President George W. Bush, is among those also slated to testify.

** A message from AHCA. Skilled nursing has been tasked with a challenge: continue to improve quality care for millions of Americans and do so on razor-thin 1.8 percent margins. Even still, the long term and post-acute care profession continues to improve lives by delivering solutions for quality care. We are AHCA. And we are the solution. Learn more at ahcancal.org/solutions.

--WHAT REPUBLICANS MEAN WHEN THEY SAY OBAMACARE “BAILOUT” — Republicans decrying the Obamacare “bailout” of insurance companies are referring to three distinct programs meant to soften the blow for insurers if their new clients are costlier to cover than expected. American Action Forum is out with a primer this morning on those so-called three Rs: Risk corridors, risk adjustment and reinsurance. The programs are the latest complex element of Obamacare to get a turn in the GOP cross hairs. AAF’s breakdown: http://bit.ly/1bllFGh

REPUBLICAN GOVERNORS HINT AT MEDICAID EXPANSION PLANS — Oklahoma Gov. Mary Fallin delivered an emphatic “no” to state lawmakers Monday night in her State of the State address. “We cannot plunge this nation further into debt, or place Oklahoma on a fiscally unsound path, by expanding Medicaid,” she said. “Both the president’s plan and alternative proposals that rely on federal dollars in the Affordable Care Act amount to the same thing: a dramatic growth in unsustainable government spending.”

--But Tennessee Gov. Bill Haslam left the door ajar. “We have to be very deliberate about making a decision to add that many and more back to the rolls, but I also understand that the decision isn’t just as easy as standing here today and saying, ‘We’re not going to expand Medicaid,’” he said during his State of the State, also on Monday. “There are hospitals across this state, many of them in rural communities, that are going to struggle if not close under the health care law without expansion, and that’s not something to take lightly.”

REPORT: BARRIERS SLOWING ADOPTION OF HEALTH I.T. — Although health IT is an emerging and promising field, the industry has been slow to adopt new technologies because of regulatory uncertainty and outdated payment policies, according to a report released Monday by the Permanente Medical Group and published in Health Affairs. Pro’s Lindsay Kalter reports: “[H]ealth remains behind other industries and full integration of such programs still face several barriers… For instance, many commercial health plans still reimburse only for in-person visits, meaning providers have scant incentive to move ahead with new types of medical consultation.” http://bit.ly/1akO1VY

INTERNISTS BACK OBAMA’S SURGEON GENERAL NOMINEE — The leaders of the American College of Physicians hailed President Barack Obama’s surgeon general nominee Monday and urged the Senate HELP Committee to advance the pick. The college’s chairman, Charles Cutler, and CEO Steven Weinberger, said the president’s pick — Vivek Murthy — “will serve the country well.” “He is a strong advocate for the provision of health insurance coverage to all Americans and is a proven leader who can build coalitions among diverse individuals to ensure better health for our communities,” the pair wrote.. http://bit.ly/1fC7e5e

ORGANIZATION TO LAUNCH “COUNTDOWN TO CURE” FOR HIV — The Foundation for AIDS Research is launching an initiative aimed at developing a cure for HIV by 2020. The organization announced Monday that the initiative, which will formally begin tomorrow, is aiming to plow $100 million into cure research over the next six years. “A decade ago, curing HIV was thought by many, if not most, in the scientific community to be impossible,” said amfAR CEO Kevin Robert Frost, in a statement. “But the science has advanced by leaps and bounds in recent years, to the extent that there is now widespread agreement among researchers that a cure for HIV is possible — and even probable.” http://bit.ly/1ifiVi0

COLORADO EYEING GEOGRAPHY’S IMPACT ON HEALTH COSTS — Colorado insurance regulators are launching a study of health care costs in response to what they describe as “concerns about higher premiums in some areas of the state.” The study follows the state Division of Insurance’s decision to preserve the market’s division into 11 geographic zones that help determine costs. “The primary aim of DOI’s health costs study will be the collection of data, while looking for variation in costs from region to region and why they occur,” the division announced.

WHAT WE’RE READING

Ten big drug companies and NIH are planning to announce a partnership aimed at developing new medicines, The Wall Street Journal reports: http://on.wsj.com/LJJAsW

Enroll America is launching a new ad campaign that relies on pets to convince people to sign up for coverage, USA Today reports: http://usat.ly/1k6bBZS

Capital New York reports that the Empire State’s request for a $10 billion waiver could hinge, in part, on efforts by CMS to collect huge Medicaid overpayments for disability centers: http://bit.ly/1akO1VY

In The Wall Street Journal, John Lechleiter, CEO of Eli Lilly & Co., argues that biopharmaceuticals are being judged based on arbitrary expectations and urges support for incremental progress: http://on.wsj.com/1blpueO

David Jolly, the Republican seeking to succeed the late Rep. C.W. Bill Young to a Florida House seat, is calling out Democrat Alex Sink for supporting Obamacare, the LA Times reports: http://lat.ms/1fVeibs

** The skilled nursing and assisted living profession is not a bystander in the budget debate. Our long term and post-acute care providers know that smart policies result in better care and more balanced budgets. With operating margins teetering dangerously at 1.8 percent, we know that actions must take the place of rhetoric. Our profession is offering solutions to issues that make a difference in patients’ lives and Medicare’s budget, such as reducing hospital readmissions, improving patient outcomes and increasing quality care in America’s skilled nursing and post-acute care centers. But these solutions are just the beginning. We are AHCA and NCAL. And we are the solution. Learn more at ahcancal.org/solutions.